May 082015
Claire Roche

Claire Roche

Two weeks have passed since I attended the International Forum on Quality and Safety in Healthcare (#Quality2015) with colleagues from NHS Wales. It was a Forum packed full of learning and here are some of my highlights from across the three days.


Wednesday 22 April

The team and I had an early start… The first job I decided to do was take off the high heels and put my sensible flat shoes on…which of course brought the comments about my height!

The day started with a very good keynote speech from Maureen Bisognano – Inspiring a new generation of healthcare improvers. She spoke about the need to have certain skills and attributes necessary for quality improvement. As well as having improvement skills and good teamwork, she also talked about the need to be curious: to be interested and excited in the things that we do. Given that I am a very curious person (some would call it nosey!), this message resonated with me. We need to encourage health professionals to constantly be curious and ask; Why can’t we? Why don’t we? Asking the questions and being curious are the first steps in improving what we do – this was a great attitude to take into 3 days of learning ahead.

For me, the best part of Maureen’s speech was her introduction to the word “exnovate”. Rather than innovation, ‘exnovation’ is stopping doing the things we know don’t work. It seems to me that this is aligned with the work happening in Wales around prudent healthcare, but I really like this word and I think that health professionals will understand this concept. Most of all, I feel this language allows or gives us permission to stop doing the things that don’t work. In particular, the things we do “because we always have!”.

Thursday 23 April

Day two brought a number of highlights for me. Firstly, I met an Improvement Advisor from Ghana called Josephine who works for the Fives Alive project. This focuses on helping Health workers in Ghana to improve the processes of care during pregnancy, childbirth, postnatal care and care of the infant and child up to the age of five. Why? Because the current mortality rate in children less than five years old in Ghana is estimated at 74 per 1000 live births.

Josephine explained a project to me where pregnant women are encouraged to receive antenatal care. She explained that in a district in Ghana where there has been an increase in women receiving health care during their pregnancy, the stillbirth rate in that district has declined. While the challenges in Ghana may be very different to the challenges we face in Wales, some issues are universal. One of the public health messages that we need to communicate to women in the UK to reduce their risk of having a stillbirth is to “attend all your antenatal appointments”. Not so very different to Ghana.

Another highlight was witnessing all the positive feedback that Paul Gimson, our National Primary Care Manager, received following his presentation on “Co-producing a prudent future for NHS Wales”. It was great to see so many people coming to the NHS Wales stand to actively seek Paul out to speak to him and want to know more about prudent healthcare. Well done Paul!

Friday 24 April

There are times when you hear someone speak and their story or message is so powerful that you know you will remember it for a long time to come. Many years ago, I heard an obstetrician who regularly undertook the role of expert witness at court cases of medical negligence speak at a conference. I recall him describing the drug syntocinon as a drug that commanded the utmost respect. His words have never left me and whenever I have cared for a woman having a syntocinon infusion, I always treat the drug with caution and the “respect” he talked about.

Similarly, I will not forget the keynote speech given by Martine Wright. Martine told her story of losing both her legs during the London bombings in 2007. Rather than seeing this devastating event as changing her life in a negative way, she spoke of how it changed her life for the better; how she had gone on to do things she would never have done, in particular competing in the 2012 paralympic games in the women’s sitting volleyball team. I sat and listened to her admiring her spirit and courage and asking myself…. What would I do? How would I react? Would I be as courageous as Martine? Would I adapt?

Thankfully, most of us will never have the traumatic experience that Martine encountered. However, in some small way I guess we are all faced with challenging situations especially when we embark on quality improvements that require change. Sometimes, we all have to be brave.

Claire Roche is the Maternity Network Wales Manager at 1000 Lives Improvement.

Catch up on sessions and keynote speeches from the International Forum on Quality and Safety in Healthcare here.

Got some thoughts on any of Claire’s highlights? Join the conversation by leaving a comment below or connecting on Twitter @1000LivesPlus and @ClaireRoche5.

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